Journal of Family & Reproductive Health

Comparing Cesarean Scar Defect Incidence After Locked and Unlocked Repair Methods Among Primiparous Patients: A Randomized Double-blinded Trial

Azadeh Tarafdari — 2024-10-13

Objective: To compare residual myometrial thickness (RMT) and cesarean scar defect (CSD) development after cesarean section using double-layer locked and unlocked closure techniques.

Materials and methods: We conducted a randomized double-blinded trial comparing double-layer locked and unlocked uterine closure techniques following cesarean section in primiparous women. The locked technique involved continuous suturing of the full myometrial thickness in the first layer, followed by back-and-forth needle maneuvering on both sides of the incision for the second layer. The unlocked method included running suturing of two-thirds of the myometrial thickness in the first layer, followed by suturing the upper half of the myometrial thickness in the second layer. Transvaginal ultrasonography was performed one year post-cesarean section, with RMT as the primary outcome and scar depth and width as secondary outcomes. Independent t-test and Chi-square test were utilized for statistical analysis.

Results: All 30 patients from the locked and 26 from the unlocked group in the follow-up were diagnosed with CSD (scar depth>2mm). The mean RMT for the unlocked and locked groups were 4.44±1.07mm and 4.12±0.48mm, respectively, showing no significant difference (p =0.14). There was also no significant difference in mean scar width between the locked and unlocked groups (3.68±1.44mm vs. 3.95±1.00mm, p =0.42). However, the mean scar depth was higher in the unlocked group (3.77±1.11 mm vs. 3.16±1.1mm, p =0.04).

Conclusion: We have found no significant differences in the RMT and CSD prevalence between
two-layered locked and unlocked uterine closure techniques, while the scar depth was greater in the unlocked group. Nonetheless, future randomized trials implementing larger sample sizes are required to precisely compare the outcomes of the double-layer locked and unlocked uterine suturing techniques

Sexual Function and Quality of Life in Iranian Women With Human Papillomavirus Infection

Afsaneh Tehranian — 2024-10-13

Objective: Considering the prevalence of Human Papillomavirus (HPV) infection and the lack of HPV vaccination program in Iran among young women and the importance of quality of life and sexual performance in women, we decided to conduct a study to examine the relationship between HPV infection and sexual dysfunction and quality of life in Iranian women.

Materials and methods: In this cohort study, 250 married women who infected with HPV were recruited via convinence sampling from colposcopy clinic of Arash women hospital (Tehran, Iran) from April 2020 to May 2022.They were evaluated concerning their sexual function in the domains of desire, arousal, lubrication, orgasm, satisfaction and pain with the female sexual function index (FSFI) questionnaire (the total FSFI score is calculated by the sum of the nineteen items). Sexual quality of life-female (SQOL-F) items (Likert-type scale with a cut-off of 65 points) were organized into four sub-scales: psychosexual feelings, sexual and relationship satisfaction, self-worthlessness, and sexual repression. All patients filled out the female sexual function index (FSFI) and sexual quality of life (SQOL) questionnaires. Variables were analysed via correlation coefficient and linear regression tests.

Results: Mean age and mean marriage duration were 38.5±4.5 and 12.2±7.2, respectively. There was a weak correlation between FSFI and SQOL (r=0.15, p=0.001).Time of marriage and genital warts were the predictors on the FSFI and SQOL.

Conclusion: The findings suggest that HPV infection can impair sexual function and quality of life. This research contributes valuable insights, especially considering the prevalence of HPV.

The Impact of Labor Oxytocin Use on Newborn Liver Enzymes

Samira Abodollahi — 2024-10-13

Objective: Oxytocin is commonly used during labor and delivery for induction of labor and prevention of postpartum hemorrhage. While previous studies have explored the effects of labor oxytocin use on maternal and neonatal outcomes, there is a paucity of research on its impact on newborn liver enzyme function. This study aimed to assess the effects of labor oxytocin use on liver enzyme function in newborns.

Materials and methods: A case-control study was conducted. The case group consisted of 70 newborns whose mothers received oxytocin during labor, while the control group consisted of 70 newborns whose mothers did not receive oxytocin. Complete blood count (CBC), lactate dehydrogenase (LDH), creatine phosphokinase (CPK), aspartate aminotransferase (AST), alanine aminotransferase (ALT), and total and indirect bilirubin levels were measured in all newborns on the second day of life.

Results: The levels of AST and total and indirect bilirubin were found to be higher in the case group than in the control group (51 vs. 42, 7.8 vs. 4.6, and 7.4 vs. 4, respectively; p < 0.005). The levels of CPK and LDH were also higher in the case group (p < 0.005). However, the difference in ALT levels was not significant between the study groups.

Conclusion: The observed increase in liver enzymes in this study can indicate the effect of maternal oxytocin on the newborn's liver function. While the changes in liver enzyme levels due to oxytocin use were not found to be high enough to cause liver damage, the increase in CPK and LDH levels could potentially elevate bilirubin levels due to hemolysis. Further research is needed to confirm these findings and explore the underlying mechanisms.

Health-Related Quality of Life among Iranian Women with Uterine Fibroids: A Cross Sectional Study

Hanieh Najafiarab — 2024-10-13

Objective: Uterine fibroids (UFs) are the most common benign tumors in women, and their prevalence varies between 5.4 and 77.0% in reproductive-aged women. Patients with UFs may experience severe symptoms that they can affect different aspects of their lives, including quality of life. This study aimed to investigate the health-related quality of life among Iranian women with UFs.

Materials and methods: This cross-sectional study was conducted at Imam Hossein Hospital, Tehran, Iran, between November 2023 and February 2024, Data collection was based on the census method. Uterine Fibroid Symptom and Health-related Quality of Life (UFS-QOL) questionnaire was used to assess symptom severity and health-related quality of life (HRQOL) of women with UFs. Data were analyzed using the SPSS software version 23.0.

Results: Overall, 220 patients with a mean age of 43.10±5.01 years were included in the study. Patients had total UFS-QOL score of 64.11±20.35 with the following subscales’ scores: symptom severity: (19.00±6.39), concern: (60.79±26.47), activities: (71.76±23.02), energy/mood: (54.39±25.14), control: (66.52±22.82), self-consciousness: (77.63±26.39), and sexual function: (59.40±31.18). Furthermore, patients with multiparity history (P= 0.001), obesity (P<0.001), increased menstrual duration (P<0.001), irregular menstruation (P<0.001), and hyper menorrhea (P<0.001) had lower HRQOL scores.

Conclusion: All subscales’ scores of HRQOL were over 50 in patients with UF. HRQOL in these patients can be affected by certain factors, such as features of the menstrual cycle, multiparity, and obesity.

The Most Common Side Effects, Concerns and Discontinuation Patterns of Oral Contraceptive Pills Among Polish Women: A Cross-Sectional Study

Natalia Karpowicz — 2024-10-13

Objective: Over the decade, variety and effectiveness of contraception methods have greatly improved, resulting in increased popularity of oral contraceptive pills (OCPs). However, hormonal contraception carries the risk of multiple side effects. The lack of sufficient knowledge often leads to the development of health concerns, which can affect patient’s adherence. The aim of our research was to describe a side effect profile of OCPs and assess the most frequent concerns and discontinuation reasons in Polish women. The survey included questions regarding OCPs utilization patterns, side effects, health concerns and attitudes of the responders.

Materials and methods: This cross-sectional study was based on a survey, which was distributed online and open from 29 April to 15 May 2022. The survey included questions regarding OCPs utilization patterns, side effects, health concerns and attitudes of the responders.

Results: Out of 1699 respondents, the current OCPs intake was reported by two thirds of women and 22% had a history of using them in the past. Seventy-nine percent of all OCPs users experienced adverse effects while 9% reported having concerns about safety and potential adverse effects. Decreased libido and weight gain were the most significant reasons for ceasing hormonal contraception. Moreover, the most common concerns and the most unfavorable side effects varied in different age groups. The occurrence of anxiety depended on age and education.

Conclusion: Healthcare professionals prescribing OCPs should provide their patients with comprehensive counseling. Understanding and addressing concerns of young women can improve their compliance and reduce the number of unintended pregnancies.

Design and Psychometrics of the Sexual-Reproductive Needs and Concerns Scale of Iranian Never-Married Women Over 35

Shakiba Pourasad Shahrak — 2024-10-13

Objective: The purpose of the present study was to design the Farsi Scale of Sexual-Reproductive Needs and Concerns of never-married women over 35 and to assess its psychometric properties.

Materials and methods: This mixed method research had two phases. The first phase was qualitative (Conventional Content Analysis). We interviewed never-married Iranian women over 35; from their responses, we extracted specific statements which to be used as questionnaire items. To validate the questionnaire psychometrically, we tested its validity (face, content, and structure) and reliability (internal consistency and stability). For qualitative face validity, 15 never-married women and 5 experts commented on the style of sentences. For quantitative face validity, we used the impact score. For qualitative content validity, 15 experts commented on the items based on their appropriateness, and for quantitative content validity, we performed the Content Validity Ratio and Content Validity Index. Exploratory Factor Analysis was used to Construct Validity. To evaluate structural validity, a cross-sectional sample of 240 never-married women over the age of 35 completed the questionnaire. Cronbach’s Alpha was used for internal consistency. In addition, the test-retest method and Intraclass Correlation Coefficient were used to ensure stability.

Results: The Sexual-Reproductive Needs and Concerns Scale of Iranian Never-Married Women over
35 was developed with 15 items and three dimensions (Emotional burden; Sexual needs; Stigma). Cronbach's alpha for the instrument was 0.81 and the Intraclass Correlation Coefficient was 0.98.

Conclusion: The results of the study showed that the developed scale has acceptable validity and reliability, and thus can be used to assess the sexual-reproductive needs and concerns of never-married Iranian women of 35 and over.

The Moderating Effect of Gender Role in Relationship Between Emotional Divorce and Marital Satisfaction: Comparison of Partial Least Square (PLS) And Consistent Partial Least Square Methods (PlSc) Methods

Farideh Khosravi — 2024-10-13

Objective: Emotional divorce refers to a state of emotional disengagement from one's spouse, which can lead to marital dissatisfaction. Gender role conflict is a predictor of marital dissatisfaction and ultimately, divorce. The literature suggests that rigid adherence to traditional gender roles may contribute to emotional divorce. In this article, the authors aim to investigate the moderating effect of gender roles in the relationship between emotional divorce and marital satisfaction by using two multivariate methods in statistical analysis.

Materials and methods: This cross-sectional study was conducted on 539 women aged 18-65 years. The standard questionnaires used include 1) Bem Sex Role Inventory (Short form), 2) Gutman’s Emotional Divorce Questionnaire, and 3) Evaluation and Nurturing Relationship Issues, Communication and Happiness (ENRICH) Marital Satisfaction (EMS) Scale. To achieve the purpose of the study, PLS and PLSc methods have been used.

Results: The mean age and time of marriage were 33.88 ± 6.6 and 13.03 ± 7.29 years. There is a significant negative relationship between emotional divorce and marital satisfaction. The gender role of most participants in the study has been androgenic and feminine, which has increased the moderating effect of this relationship. Also, when there is a common (reflective) factor model, Consistent Partial Least Square is more likely to provide a better fit than Partial Least Square.

Conclusion: The results showed that higher women's marital satisfaction would be associated with lower emotional divorce. On the other hand, the role of gender is a mediating factor in marital satisfaction and emotional divorce. Having good male and female characteristics can have a positive impact on marital satisfaction, so increasing couples' knowledge of gender roles and trying to reduce traditional extreme roles can help increase marital satisfaction and reduce emotional divorce.

Silent Intruders: Recurrent Suture Granuloma Unveiled in Caesarean Scar

Arun Sanap — 2024-10-13

Objective: To describe the clinical and radio-pathological features of suture granuloma, an inflammatory response to retained suture material that primarily affects non-absorbable sutures.

Case report: We report a case of a 26-year-old female presenting with painful swelling at a caesarean section scar, previously excised for similar complaints. Physical examination revealed a solid soft tissue mass on the scar. Magnetic resonance imaging (MRI) identified a 2x2 cm lesion in the right abdominal wall, suggestive of suture granuloma. Surgical excision revealed prolene suture material within the granulomatous tissue. Histopathology confirmed foreign body reaction.

Conclusion: Recurrence post-prior excision underscores the importance of complete granuloma removal. Differential diagnoses included scar endometriosis and inflammatory lesions. Suture granulomas, though rare, require consideration in scar-related swelling. Collaboration between specialties ensures accurate diagnosis and management.

Anticipating and Executing off Beat Pregnancies in Müllerian Duct Anomalies: A Case Series

Satyasri Koya — 2024-10-13

Objective: Müllerian duct Anomalies (MDA) are rare but well-known entity. Most of the MDAs are asymptomatic, and are undiagnosed; However, MDAs may present with infertility, bad obstetric history or other associated anomalies which further fuel the suspicion of MDAs. This case series comprises of 6 problem-pregnancies, their course and management.

Case report: Primigravida with bicornuate uterus presented at 23 weeks with hand prolapse, requiring hysterotomy. A G2P1L0 presented at 36 weeks with footling presentation, managed by a preterm CS. Primigravida presented at 24 weeks with Didelphys uterus with partial longitudinal vaginal septum, needing hysterotomy. Primigravida at 37 weeks presented with abruptio placenta, managed by CS.

Conclusion: Though the incidence of MDAs is low, but the outcomes can be rather distressing for both mother and fetus. Once identified, adverse outcomes must be anticipated and prepared for, and these are best managed at tertiary hospitals. Apart from counselling we should also meticulously document, improve awareness regarding MDAs and their outcomes. Early diagnosis and timely management can hit the jackpot in terms of pregnancy outcomes.

Determinants of Non-Acceptance of the COVID-19 Vaccine During Pregnancy in Pregnant and Postpartum Women: Correspondence

Hinpetch Daungsupawong — 2024-10-13

The Article Abstract is not available.